Kara Shirley Pharmd, Bcps, Bcpp, Bcacp, Cpgx Email & Phone Number

Duluth, Mn, Us

San Francisco, Ca, Us

“If you’re going to face a real challenge it has to be a real challenge. You can’t accomplish anything without the possibility of failure.” Lazarus Lake- The Barkley Marathons"Unlocking the power of remote mentorship, connecting pharmacists, technicians, and pharmacy students to actionable insights and knowledge."

New York, Ny, Us

Scottsdale, Arizona, Us

Tampa, Florida, Us

Portland, Oregon, Us

One of eleven pharmacists internationally to hold Psychiatric, Pharmacotherapy and Ambulatory Care board certifications. concurrently. Driven to empower providers and patients through telemedicine and clinical consultation. As an invited OHSU Project ECHO expert faculty member (Child Psychiatry), she has also enthusiastically participated in weekly case discussion with approximately forty (40) primary care and pediatrician practices throughout the State of Oregon (2018-2023).

San Francisco, California, Us

Clinical Pharmacist Lead- Washington State (Medicaid Care Organization Contractor (CIN/ACO (FFS))• Coaching and improving primary care physicians' prescribing behaviors, redirecting care to cost-effective solutions, and providing education, medication titration, and support (including with PAs, complex infusions, and DME) to patients receiving Medicaid benefits.• Develop and test protocols and processes for pharmacists assisting primary care providers, community health workers, social workers, and care coordinators to improve care outcomes for patients receiving Medicaid• Communicate with patients and providers through multi-modal CRMs including multiple EHRs, text, phone, and video• Work with analytics and engineering teams to develop and use dashboards for pharmacists to proactively outreach patients• Participate in QI activities to assure quality, cost-effectiveness, and ROI• Potentially hire, mentor and supervise junior pharmacists and pharmacy technicians

Seattle, Wa, Us

Working Each Day to Make a Difference At Community Health Plan of Washington, we’re driven by our belief that everyone deserves access to quality health care. We are a local not-for-profit health plan in Washington State. We are committed to keeping Washington families healthy. PRINCIPAL DUTIES: Performs clinical reviews for override requests and appeals Serves as a drug expert who will provide clinical consultation to Community Health Plan of Washington internal and external customers Performs clinical in-service to Community Health Plan of Washington internal or external customers as needed Supports evidence-based pharmacy clinical intervention programs Develops provider and member communication materials Monitors and audits activities performed by Community Health Plan of Washington’s pharmacy benefit manager to ensure compliance with regulatory, contractual and accreditation requirements Perform medication reviews and medication reconciliation for members and work within interdisciplinary care teams to support member clinical needs Support pharmacy clinical quality program initiatives Develops policy and procedures for pharmacy benefit management Monitors, identifies and addresses potential fraud, waste and abuse activities related to pharmacy Helps inform provider groups regarding adverse drug utilization trend to ensure appropriate medication use Assists in monitoring guidance from CMS and implementing required processes to ensure Part D compliance including CDAG and formulary administration Serves as a pharmacy point of contact for selected Community Health Plan of Washington’s delegated entities Supports clinical review for Patient Review and Coordination program to ensure appropriate care coordination and patient safety

Every employee shares the responsibility for achieving the Quadruple Aim of health care reform: member engagement and satisfaction, improving quality of care, managing costs, and honoring diversity and equity by focusing on the member doing what is right and thinking. JOB PURPOSE:This position is responsible for reviewing pharmacy claims and processing pharmacy prior authorizations.ESSENTIAL RESPONSIBILITIES: Coordinated Care Organization Pharmacy Benefit Coordination1. Maintain working knowledge related to members enrolled in the Oregon Health Plan (OHP)2. Work with Utilization Management Team including Chief Medical Officer, MD Reviewer, Manager of Medical Services and other staff as appropriate, to ensure that authorizations are processed according to organizational and State required guidelines3. Renders clinical decisions based on Oregon Administrative Rules, Line Finder (prioritized list), prior authorization criteria, and Advanced Health’s current formulary4. Acts as a liaison with pharmacy providers, medical providers, and third-party administrators (Pharmacy Benefit Administrator [PBM]) to ensure efficient processing of data and claims5. Manages the processing of all pharmacy claims through a PBM6. Analyzes claims for appropriateness of services and interprets benefits in accordance with established contracts7. As directed, assist with the maintenance of the Advanced Health Formulary8. Participate in quality and organizational process improvement activities and teams when requested9. Ensure compliance with company policies and procedures as applicable to area(s) of responsibility10. Handle confidential information and materials appropriately and maintains a secure work area

Corvallis, Oregon, Us

Salem, Oregon, Us

Oregon Health Authority Legislative Workgroup (HB 2300/SB 138), Governor appointed Member and Founding Vice Chair

Portland, Or, Us

Portland, Or, Us

Portland, Or, Us

Portland, Or, Us

Portland, Or, Us

Deerfield, Il, Us

Minneapolis, Mn, Us

Bangor, Me, Us

Pittsburgh, Pa, Us

Woonsocket, Ri, Us

Pittsburgh, Pennsylvania, Us

Deerfield, Il, Us

San Antonio, Tx, Us

Pharmd With Distinction, Pharmacy

Fellowship, Clinical Neuropsychopharmacology

Pgy2 (Ashp Pgy-1 Exempt), Psychiatric Pharmacy Practice Residency

Education record

Agents Of Change Fellowship- Lean Green Belt In Healthcare, Process Improvement

Certificate Program, Pharmacogenomics And Precision Medicine